Solid Tumor Embolotherapy in Hepatic Arteries with an Anti-reflux Catheter System

被引:17
作者
Xu, Zelin [1 ]
Jernigan, Shaphan [1 ]
Kleinstreuer, Clement [1 ,2 ,3 ]
Buckner, Gregory D. [1 ,2 ,3 ]
机构
[1] N Carolina State Univ, Dept Mech & Aerosp Engn, Raleigh, NC 27695 USA
[2] N Carolina State Univ, Joint Dept Biomed Engn, Raleigh, NC 27695 USA
[3] Univ N Carolina, Raleigh, NC 27695 USA
关键词
Liver cancer; Transient particle-hemodynamics; Embolization; Particle-reflux; Infusion-stop point; Excessive particle capture; SUREFIRE INFUSION SYSTEM; COIL EMBOLIZATION; BLOOD-FLOW; HEPATOCELLULAR-CARCINOMA; Y-90; RADIOEMBOLIZATION; MICROSPHERES;
D O I
10.1007/s10439-015-1411-7
中图分类号
R318 [生物医学工程];
学科分类号
0831 ;
摘要
Unresectable hepatoma accounts for the majority of malignant liver tumor cases for which embolization therapy is considered a viable treatment option. However, the potential risk of aberrant particle deposition in non-target regions could cause severe side-effects, alongside diminished efficacy. A computational model has been developed to analyze the particle-hemodynamics before and after deployment of an FDA-approved anti-reflux catheter. The catheter features a retractable, porous cone-like tip designed to allow forward blood flow while preventing microsphere reflux. A patient-specific hepatic artery system, with different daughter branches connected to a liver tumor, was chosen as a representative test bed. In vitro as well as in vivo measurements were used to validate the computer simulation model. The model captures the effect of tip-deployment on blood perfusion and pressure drop in an interactive manner under physiologically realistic conditions. A relationship between the pressure drop and embolization level was established, which can be used to provide clinicians with real-time information on the best infusion-stop point. However, the results show that the present procedure for embolization of downstream vessels which feed a tumor is quite arbitrary. Nevertheless, a method to recycle aberrant particles captured by the deployed tip was proposed to minimize side-effects.
引用
收藏
页码:1036 / 1046
页数:11
相关论文
共 25 条
  • [11] COMPUTER MODELING OF YTTRIUM-90-MICROSPHERE TRANSPORT IN THE HEPATIC ARTERIAL TREE TO IMPROVE CLINICAL OUTCOMES
    Kennedy, Andrew S.
    Kleinstreuer, Clement
    Basciano, Christopher A.
    Dezarn, William A.
    [J]. INTERNATIONAL JOURNAL OF RADIATION ONCOLOGY BIOLOGY PHYSICS, 2010, 76 (02): : 631 - 637
  • [12] A New Catheter for Tumor Targeting With Radioactive Microspheres in Representative Hepatic Artery Systems. Part I: Impact of Catheter Presence on Local Blood Flow and Microsphere Delivery
    Kleinstreuer, C.
    Basciano, C. A.
    Childress, E. M.
    Kennedy, A. S.
    [J]. JOURNAL OF BIOMECHANICAL ENGINEERING-TRANSACTIONS OF THE ASME, 2012, 134 (05):
  • [13] Kleinstreuer C., 2014, Microfluidics and Nanofluidics: Theory and Selected Applications
  • [14] Hepatic embolotherapy in interventional oncology: Technology, techniques, and applications
    Kritzinger, J.
    Klass, D.
    Ho, S.
    Lim, H.
    Buczkowski, A.
    Yoshida, E.
    Liu, D.
    [J]. CLINICAL RADIOLOGY, 2013, 68 (01) : 1 - 15
  • [15] The Road Less Traveled: Importance of the Lesser Branches of the Celiac Axis in Liver Embolotherapy
    Lee, Aram J.
    Gomes, Antoinette S.
    Liu, David M.
    Kee, Stephen T.
    Loh, Christopher T.
    McWilliams, Justin P.
    [J]. RADIOGRAPHICS, 2012, 32 (04) : 1121 - +
  • [16] Arterial embolisation or chemoembolisation versus symptomatic treatment in patients with unresectable hepatocellular carcinoma:: a randomised controlled trial
    Llovet, JM
    Real, MI
    Montaña, X
    Planas, R
    Coll, S
    Aponte, J
    Ayuso, C
    Sala, M
    Muchart, J
    Solà, R
    Rodés, J
    Bruix, J
    [J]. LANCET, 2002, 359 (9319) : 1734 - 1739
  • [17] Experimental Microsphere Targeting in a Representative Hepatic Artery System
    Richards, Andrew L.
    Kleinstreuer, Clement
    Kennedy, Andrew S.
    Childress, Emily
    Buckner, Gregory D.
    [J]. IEEE TRANSACTIONS ON BIOMEDICAL ENGINEERING, 2012, 59 (01) : 198 - 204
  • [18] Downstream Hepatic Arterial Blood Pressure Changes Caused by Deployment of the Surefire AntiReflux Expandable Tip
    Rose, Steven C.
    Kikolski, Steven G.
    Chomas, James E.
    [J]. CARDIOVASCULAR AND INTERVENTIONAL RADIOLOGY, 2013, 36 (05) : 1262 - 1269
  • [19] Survival After Yttrium-90 Resin Microsphere Radioembolization of Hepatocellular Carcinoma Across Barcelona Clinic Liver Cancer Stages: A European Evaluation
    Sangro, Bruno
    Carpanese, Livio
    Cianni, Roberto
    Golfieri, Rita
    Gasparini, Daniele
    Ezziddin, Samer
    Paprottka, Philipp M.
    Fiore, Francesco
    Van Buskirk, Mark
    Bilbao, Jose Ignacio
    Ettorre, Giuseppe Maria
    Salvatori, Rita
    Giampalma, Emanuela
    Geatti, Onelio
    Wilhelm, Kai
    Hoffmann, Ralf Thorsten
    Izzo, Francesco
    Inarrairaegui, Mercedes
    Maini, Carlo Ludovico
    Urigo, Carlo
    Cappelli, Alberta
    Vit, Alessandro
    Ahmadzadehfar, Hojjat
    Jakobs, Tobias Franz
    Lastoria, Secondo
    [J]. HEPATOLOGY, 2011, 54 (03) : 868 - 878
  • [20] SPLENIC ARTERY AND SUPERIOR MESENTERIC-ARTERY BLOOD-FLOW - NONSURGICAL DOPPLER US MEASUREMENT IN HEALTHY-SUBJECTS AND PATIENTS WITH CHRONIC LIVER-DISEASE
    SATO, S
    OHNISHI, K
    SUGITA, S
    OKUDA, K
    [J]. RADIOLOGY, 1987, 164 (02) : 347 - 352